The training challenge in health informatics
Carol Harris
No-one knows exactly how many health informaticians are working in the NHS, although past surveys have put the figure at 29,000. As the numbers have grown, so the work and the education and training needs have increased in volume and scope.
But such a large and essential group of staff have no agreed career structure, no professional body and no regulation.
Does it matter? After all, there are thousands of staff working the health service in technical and managerial jobs who don’t have professional regulation.
Dr Glyn Hayes, chairman of the UK Council for Health Informatics Professions (UKCHIP), believes that as the scope of health informaticians work increases, an unregulated profession is an increasingly dangerous prospect.
That and the more positive aspects of core standards of training and continuing professional development have led the organisation to set up a voluntary register for health informaticians. UKCHIP, which exists to promote professionalism in health informatics, is also talking to the Health Professions Council about compulsory registration, which would create a closed profession.
Getting training taken seriously
Just over 900 people are fully registered with UKCHIP but about 2,000 more registrations are in the pipeline. “The uptake of registration has slower than we would have liked mainly because the only reason for registering with us at present is personal satisfaction,” says Dr Hayes.
“HI [health informatics] is not recognised as a profession by managers. That is one reason why one of our biggest targets at the moment is getting management to take training seriously.”
Ethical behaviour of members is another crucial concern and vital to a profession with standards which are independent of their employers.
“UKCHIP was created to help improve patient safety,” Dr Hayes says. “There is a lot of pressure on IT people to deliver and people make the assumption that if you put enough pressure on, then it will work.
“We hear anecdotes about data being manipulated to produce required outcomes; it is a way of life for some in IT. But a registered health informatician would be struck off for that. Clinical records are another example: patients are at risk if they are not maintained properly.”
Multiple pathways to agreed standards
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"Health informaticians came very badly out of Agenda for Change: they were put down as administrative staff and are still seen as people who fix computers and set up networks" -- Dr Glyn Hayes, chairman of UKCHIP |
“One of the things we are doing at the moment in UKCHIP is to set out what health informaticians should know and what training is required.
“St George’s Medical School is beginning undergraduate courses in HI so we are also getting school leavers into the mix. But if there is a typical path in training, it usually means a postgraduate degree such as an MSc in HI.”
That said, he believes, “We must draw in more school leavers, although there will always be a need for NHS clinical staff.”
The current lack of a career structure in the NHS means that HI specialists are often buried in finance departments. “Health informaticians came very badly out of Agenda for Change: they were put down as administrative staff and are still seen as people who fix computers and set up networks,” says Dr Hayes.
Providing continuing professional development
Registration as professionals would also boost the case for providing continuing professional development. Currently, this is often under-resourced for health informaticians and does not emphasise reflective practice, the approach favoured many other staff groups including nurses.
But Colin Jervis, acting director of IT at University College London Hospitals NHS Foundation Trust, has reservations about the push towards accredited training and a registered profession.
“The tendency now is to compare health informatics to engineering but although HI has a hard side - these are the ways to do things, this is the information you need and so on - it also has an equally important soft side. In that sense, I believe change management skills will be easily as necessary as any amount of hard information in the future.
“Healthcare IT also needs to be inspirational, helping people to do their jobs and helping patients to use information in ways which they had not realised was possible. We need creative thinking, strong interpersonal skills and the ability to challenge.
“Things are changing: I get a lot of support for what I do here and clinicians recognise what HI can do for them, but IT staff generally have been undervalued by the NHS - part of the problem is the National Programme for IT, which has drained people away from local health providers. Another issue is that fantastic amounts of money have been paid to IT organisations from outside.”
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